Retrieval Basket Apparatus

ABSTRACT

An object removal tool including a basket device having a basket section; a sheath on the basket device, where the sheath is adapted to longitudinally slide on the basket device; and a control connected to the basket device and the sheath. The control is configured to longitudinally move the sheath on the basket device to close the basket section on an object.

BACKGROUND

1. Technical Field

The exemplary and non-limiting embodiments relate generally to a devicehaving a basket and, more particularly, to a method and apparatus for aclosable basket.

2. Brief Description of Prior Developments

U.S. Pat. No. 6,764,499 discloses a medical device with a basket. U.S.Pat. No. 8,211,115 discloses a variable size retrieval basket.

SUMMARY

The following summary is merely intended to be exemplary. The summary isnot intended to limit the scope of the claims.

In accordance with one aspect, an object removal tool is providedcomprising a basket device comprising a basket section; a sheath on thebasket device, where the sheath is adapted to longitudinally slide onthe basket device; and a control connected to the basket device and thesheath. The control is configured to longitudinally move the sheath onthe basket device to close the basket section on an object.

In accordance with another aspect, an apparatus comprises an endoscopehaving a shaft with a lens at a distal end; and an object removal toolconnected to a port of the endoscope. The object removal tool comprisesa basket device and a control. The basket device comprises a basketsection for capturing an object. The control is configured to close thebasket section around the object. The endoscope and the control areconfigured to be used by a single hand of a user at a same time.

In accordance with another aspect, a method comprises connecting anobject removal tool to an endoscope including inserting a portion of theobject removal tool into a port of the endoscope; and rotating a sheathof the object removal tool to cause the sheath to longitudinally sliderelative to the basket device.

In accordance with another aspect, a method comprises connecting asheath to a basket device for longitudinal only movement on the basketdevice in the sheath, where a distal end of the basket device comprisesa basket section; connecting a proximal end of the basket device to abracket; connecting the bracket to a holder, where the bracket islimited to longitudinally slide along a first length of travel of thebracket on the holder and is rotatable on the holder at an end of thefirst length of travel, where the holder is configured to connect to aport of an endoscope; and connecting the sheath to a cam where the camis configured to longitudinally move the sheath when the sheath and thecam are rotated relative to each other.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing aspects and other features are explained in the followingdescription, taken in connection with the accompanying drawings,wherein:

FIG. 1 is a perspective view of an example embodiment;

FIG. 2 is a side view of a distal end of an assembly comprising a sheathand a basket device;

FIG. 3 is a side view of the control of the tool shown in FIG. 1;

FIG. 4 is a partial perspective view of a proximal end of the tool shownin FIG. 1;

FIG. 5 is a partial perspective view with a cut away section of theproximal end of the tool shown in FIG. 4;

FIGS. 6-9 are perspective views illustrating how a user may hold and usethe example embodiment with one hand.

DETAILED DESCRIPTION OF EMBODIMENTS

Referring to FIG. 1, there is shown a perspective view of an apparatus10 and tool 30 incorporating features of an example embodiment. Althoughthe features will be described with reference to the example embodimentshown in the drawings, it should be understood that features can beembodied in many alternate forms of embodiments. In addition, anysuitable size, shape or type of elements or materials could be used.

The apparatus 10 in this example is a endoscope medical deviceconfigured to be partially inserted into a patient's body, such as inthrough the patient's urethra. The apparatus 10 generally comprises acontrol section 12 and a shaft 14. The control section 12 is sized andshaped to be grasped by the user's hand. In the example embodimentshown, the control section 12 includes a connector 16 which is a fiberoptics light post. The light post 16 may be connected to a light source.Features as described herein may be configured to work with a fiberoptic endoscope or a digital endoscope. The apparatus may comprise aneyepiece (see FIGS. 6-9) at a proximal end 18 of the control section 12.The apparatus has a working channel port 20, and a deflection control 22lever. However, in alternate embodiments any suitable type of controlsection could be provided.

The shaft 14 extends from the control section 12 in a general cantileverfashion. A distal end of the shaft 14 may comprise optics forming anobjective head, such as a lens and/or camera. The shaft 14 includes aworking channel 24 from the working channel port 20. The working channel24 allows fluids, tools and tissue or stones to be passed through theshaft 14. The distal end of the shaft 14 has an aperture out of theworking channel 24. The shaft 14 may include fiber optics or electricalwires to the optics in the distal tip, such as for illumination and/orvisualization, and deflection control wires are provided in the shaftbetween the deflection control lever 22 and a frame of an activedeflection section 26 of the shaft 14.

In this example, the apparatus 10 comprises a Y-adapter 32 attached tothe working channel port 20 for attaching standard connector andadditional instruments if needed. However, in an alternate example theY-adapter 32 might not be provided, or may be integrally formed with theendoscope 10. A device or tool 30 is shown attached to the workingchannel port 20 of the endoscope 10 via the Y-adapter 32. The tool 30,in this example, is a Surgeon Controlled Basket Device (SCBD). The tool30 includes a control 31 and an assembly 33.

The assembly 33 generally comprises a basket device 50 and a sheath 54.Referring also to FIG. 2, the basket device 50 comprises a basketsection 62 at a distal end, and a shaft section 64 extending through thesheath 54 to a proximal end of the tool 30. The sheath is longitudinallymovable on the basket device 50 between a forward position and arearward position. FIG. 2 shows the sheath 54 moved rearward on thebasket device 50 to the rearward position such that the basket section62 is located out from a front end aperture 66 of the sheath 54. In theforward position of the sheath 54 on the basket device 50, the basketsection 62 is located inside the sheath 54; collapsed by the sheath 54into a smaller shape to fit inside the sheath 54.

Referring also to FIGS. 3-5, the control 31 generally comprises a holder34, a bracket 36, a cam 38, and a control wheel 40. The holder 34 isadapted to connect the control 31 to the working channel port 20 (or theY-adapter 32 in this example). In this example the holder 34 comprisesan adjustable gooseneck design which is flexible. This allows adjustingthe control 31 to adapt to the hand size of the surgeon using the tool.The bracket 36 is movable connected to the holder 34. The bracket 36comprises a front section 41, a rear section 43 and a curved connectorsection 42. Bracket 36 is connected to two opposite ends of the cam 38.In particular, the cam 38 is connected between the front and rearsections 41, 43. The cam 38 can freely be rotated around the axis 68.

The control wheel 40 is mounted on the curved connector 42 and isaxially rotatable on the connector 42. The control wheel 40 contacts thecam 38 and may provide transfer of a surgeon's manual rotation of thewheel 40 to the cam 38. The front section 41 of the bracket 36 has twoslots 44, 46 which intersect and are perpendicular to each other. Slot44 is parallel to the rotation axis 68 and allows the surgeon to movethe bracket 36 forward and backward on the holder 34 as indicated byarrow 48. The perpendicular slot 46 allows for rotating the bracket 36during a surgical procedure after the bracket 36 has been moved to aforward position on the holder 34. Both slots 44, 46 work with a pin 51located on the proximal end of the holder 34.

A proximal cylindrical end of the sheath 54 of the assembly 33 extendsinto the cam 38. This sheath 54 has a pin 52. The pin 52 is located inan internal spiral surface 56 of the cam 38. The proximal cylindricalend of sheath 54 has an internal hexagon cut. As best seen in FIG. 5,the proximal end of the shaft section 64 of the basket device 50 has anoutside hexagon surface. The outside hexagon surface of the proximal endof the shaft section 64 is matingly located inside the internal hexagoncut of the proximal end of the sheath 54. This constraint allows for alongitudinal reciprocating motion of the sheath 54 relative to thebasket device 50, but limits or prevents axial rotation of the sheath 54relative to the basket device 50. The proximal end of the basket device50 is fixed with a cap 58 and locked with-nut 60 with washer 61 to therear section 43 of the bracket 36. A hexagon opening prevents the basketdevice 50 from axially rotating relative to the rear section 43 of thebracket 36.

The sheath 54 is assembled with the basket device 50, and the assembly33 is inserted into a back opening of the cam 38. Sheath 54 turns alongthe functional curve 56 of the cam 38 and moves ahead to a maximumdistal position. The basket device 50 will stay inside the sheath 54.The assembled cap 58 and nut 60 with washer 61 prevents the basketdevice 50 from rotation and secure the basket device 50 against motionalong the axis 30 relative to the bracket 36. After that, the assembledtool 30 can be attached to the endoscope working channel port 20 (orY-adapter in this example) by inserting the proximal end of the basketdevice 50 and sheath 54 into the working channel of the endoscope.

After the distal end of the assembly 33 is located at a suitablelocation to perform a task, the bracket 36 may be moved forward alongthe longitudinal slot 44 on the distal ring 41 of the bracket 36. Withthis movement both the sheath 54 with the basket device will move outfrom inside of the working channel forward past the distal end apertureof the shaft 14. In this position the tool 30 is ready for use and theuser can work with the tool (such as using only one hand) to capturefragments of kidney stones. The user may rotate the cam 38, such as byrotating the wheel 40. Rotation of the cam 38 causes the bracket 36 torotate with slot 46 moving relative to pin 51. The pin 52 on the sheathmoves in the spiral surface 56. This causes the sheath 54 tolongitudinally slide rearward on the basket device 50. Because of therelative longitudinal movement of the sheath rearward on the basketdevice 50, the basket section 62 is uncovered from being inside thesheath 54, and the basket section 62 springs into the shape shown inFIG. 2. The user may then manipulate the basket section 62 to locate thefragments into the basket section 62. Now, the user may rotate the cam38 in an opposite direction of rotation. This will cause the bracket 36to rotate in an opposite direction with the slot 46 moving relative topin 51. The pin 52 on the sheath 54 moves in the spiral surface 56. Thiscauses the sheath 54 to longitudinally slide forward on the basketdevice 50. The sheath 54, thus, is slid forward to cause the basketsection 62 to partially close and capture the fragments inside thebasket section 62. The user may then withdraw the assembly 33, removethe fragments from the assembly 33, and repeat the process to remove allthe fragments to be removed. Rotating the cam 38 around its own axislongitudinally moves the sheath 54 forward and back for closing andopening basket section 62. FIGS. 6-9 are perspective views showing howthe user may hold the endoscope and use the tool with only one hand;using the wheel or the cam directly.

Features as described herein may be used in an endoscope, such as withlithotripsy, a kidney stone retaining basket, a grasper and/or a clip-onbasket. Urology lithotripsy and surgery processes require using graspingor biopsy forceps and a retaining basket which operates by control wirethat extends through a sheath. Most existing instruments have a sliderwhich moves along a handle operating the device with a sliding motionand locking mechanism. Existing devices are designed for using two handsduring the operation. For additional manipulations (irrigation, changingaccessories . . . ), the surgeon requires some help from a medicalassistant or nurse because, in this case, both his hands are holding theendoscope and the basket manipulation device. This means that a minimumof two specialists must be involved in this procedure. In the process of“fishing” and capturing fragments of a kidney stone, the fragments arevery often lost when the basket closes. This happens because the basketis moving back and the sheath is fixed.

The example embodiment described above may be used for one handmanipulation of the endoscope and basket control device. The surgeon canhold both the endoscope and the basket control device using only onehand. The second hand can be used for additional manipulation, such aschanging and adjusting accessories and irrigation using a syringe orliquid container adapter valve. The surgeon can do the entire procedurewithout support of an additional specialist. The device allows thesheath to move with a fixed basket during open-close procedure. Thisfeature reduces the possibility of losing fragments of stones during thebasket closing process.

Features as described above may be used in a hand-operated surgicalinstrument and, more particularly, to a device which provides a controlmechanism for a stone basket for use with an endoscope allowing thesurgeon to use a single hand during the operation procedure. Theergonomic design of this device allows the surgeon to manipulate thedevice and endoscope with a single hand. The surgical instrument can beused for biopsy and grasping forceps, or a retaining basket andpotentially for laser probe and guide wires. The additional port fromthe Y-adapter allows irrigation and using a guide wire or laser withoutdetaching this device from the endoscope irrigation port. In addition,the device allows for moving the sheath with a fixed basket duringopen-close procedure. This feature, longitudinally moving the sheathrather than longitudinally moving the basket to close the basket,reduces the possibility of losing fragments of stones during the basketclosing process.

In one example embodiment, an object removal tool comprises a basketdevice 50 comprising a basket section 62; a sheath 54 on the basketdevice, where the sheath is adapted to longitudinally slide on thebasket device; and a control 31 connected to the basket device and thesheath, where the control is configured to longitudinally move thesheath 54 on the basket device 50 to close the basket section 62 on anobject, and where the control comprises a cam member 38 having a camsurface 56 adapted to cam against a portion 52 of the sheath as thesheath and the cam member are rotated relative to each other.

The control may comprise a holder 34 configured to be removablyconnected to a port of an endoscope and a bracket 36 movably connectedto the holder, where a proximal end of the basket device is fixedlyconnected to the bracket. The bracket may be limited to longitudinalsliding movement along a first length of travel of the bracket on theholder and may be rotatable on the holder at an end of the first lengthof travel. The cam member may be connected to the bracket, where thebracket is configured to axially rotate relative to the cam member. Thesheath may comprise a portion which is located in a cam slot inside thecam member. The bracket may comprises a first portion in front of thecam member, a second portion behind the cam member, a connection sectionwhich connects the first and second portions to each other, and arotatable member 40 on the connection section which contacts the cammember and is configured to rotate on the connection section and the cammember.

In an example embodiment an apparatus may comprise an endoscope having ashaft with a lens at a distal end; and an object removal tool connectedto a port of the endoscope, where the object removal tool comprises abasket device and a control, where the basket device comprises a basketsection for capturing an object, and where the control is configured toclose the basket section around the object, where the endoscope and thecontrol are configured to be used by a single hand of a user at a sametime.

The object removal tool may comprise a sheath on the basket device,where the sheath is adapted to longitudinally slide on the basketdevice, and where the control comprises a cam member having a camsurface adapted to cam against a portion of the sheath as the sheath andcam member are rotated relative to each other. The control may comprisea holder configured to be removably connected to a port of an endoscopeand a bracket movably connected to the holder, where a proximal end ofthe basket member is fixedly connected to the bracket, where the bracketis limited to longitudinally slide along a first length of travel of thebracket on the holder and is rotatable on the holder at an end of thefirst length of travel, where the sheath comprises a portion which islocated in a cam slot inside the cam member, and where the bracketcomprises a first portion in front of the cam member, a second portionbehind the cam member, a connection section which connects the first andsecond portions to each other, and a rotatable member on the connectionsection contacts the cam member and is configured to rotate on theconnection section and the cam member

An example method may comprise connecting an object removal tool to anendoscope including inserting a portion of the object removal tool intoa port of the endoscope; and rotating a sheath of the object removaltool to cause the sheath to longitudinally slide relative to the basketdevice. Rotating a sheath to cause the sheath to longitudinally sliderelative to the basket device may comprise rotating a cam member and thesheath relative to each other while preventing axial rotation of thebasket device relative to the sheath. Connecting the object removal toolto the endoscope may comprise connecting a holder of the object removaltool to the port, and inserting the sheath and the basket device throughthe port into a shaft of the endoscope, and the method further compriseslongitudinally sliding a bracket of a control of the object removal toolforward on the holder to move distal ends of the sheath and the basketdevice out of a distal end of the shaft, and then axially rotating thebracket to cause the sheath to both rotate with the basket device andlongitudinally slide on the basket device.

An example method may comprise connecting a sheath to a basket devicefor longitudinal only movement on the basket device in the sheath, wherea distal end of the basket device comprises a basket section; connectinga proximal end of the basket device to a bracket; connecting the bracketto a holder, where the bracket is limited to longitudinally slide alonga first length of travel of the bracket on the holder and is rotatableon the holder at an end of the first length of travel, where the holderis configured to connect to a port of an endoscope; and connecting thesheath to a cam where the cam is configured to longitudinally move thesheath when the sheath and the cam are rotated relative to each other.The method may further comprise connecting the holder to the port of theendoscope such that the bracket is located to be axially rotated by asingle hand of a user at a same time that the user is holding theendoscope in the same hand.

Features as described above are not limited to use with a retrievalbasket. Features as described above may be used to manipulate anysuitable type of endoscope accessory. The endoscope accessory may be aretrieval basket, or a laser probe, or an electrode, or a guide wire forexample.

In accordance with another example, an apparatus 10 may comprise anendoscope having a shaft with a lens at a distal end; and a toolconnected to a port of the endoscope, where the tool comprises a controland an endoscope accessory portion connected to the control, where theendoscope accessory portion comprises extends from the port, through aworking channel of the shaft, to a distal end aperture out of the shaft,and where the control is configured to move the endoscope accessoryportion out of the distal end aperture, where the endoscope and thecontrol are configured to be used by a single hand of a user at a sametime. The tool may be an object removal tool, where the endoscopeaccessory portion comprises a basket device comprising a basket sectionadapted to capture an object, and where the control is configured toclose the basket section around the object.

It should be understood that the foregoing description is onlyillustrative. Various alternatives and modifications can be devised bythose skilled in the art. For example, features recited in the variousdependent claims could be combined with each other in any suitablecombination(s). In addition, features from different embodimentsdescribed above could be selectively combined into a new embodiment.Accordingly, the description is intended to embrace all suchalternatives, modifications and variances which fall within the scope ofthe appended claims.

1-17. (canceled)
 18. An object removal tool comprising: a basket devicecomprising a basket section; a sheath on the basket device, where thebasket device is adapted to longitudinally slide on the sheath; and acontrol connected to the basket device and the sheath, where the controlis configured to longitudinally move the basket device on the sheath toclose the basket section on an object, where the control comprises a cammember having a cam surface adapted to cam against a portion of thebasket device as the basket device and the cam member are rotatedrelative to each other.
 19. The object removal tool of claim 18 wherethe cam member is configured to longitudinally move the basket devicewhile a proximal end of the sheath remains substantially stationary,where the cam member rotates a helix which translates the rotationalmotion to longitudinal motion via a pin, where the pin is connected tothe basket device, where the pin extends into a cutout portion of thehelix.
 20. The object removal tool of claim 19 where the controlcomprises a holder configured to be removably connected to a port of anendoscope and a bracket movably connected to the holder, where aproximal end of the sheath is fixedly connected to the bracket.
 21. Theobject removal tool of claim 20 where the bracket is limited tolongitudinal sliding movement along a first length of travel of thebracket on the holder and is rotatable on the holder at an end of thefirst length of travel.
 22. The object removal tool of claim 20 wherethe cam member is connected to the bracket, where the bracket isconfigured to axially rotate relative to the cam member.
 23. The objectremoval tool of claim 22 where the basket device comprises a portionwhich is located in a cam slot inside the cam member.
 24. The objectremoval tool of claim 22 where the bracket comprises a first portion infront of the cam member, a second portion behind the cam member, aconnection section which connects the first and second portions to eachother, and a rotatable member on the connection section which contactsthe cam member and is configured to rotate on the connection section andthe cam member.
 25. An apparatus comprising: an endoscope having a shaftwith a lens at a distal end; and an object removal tool as in claim 18connected to a port of the endoscope.
 26. An apparatus comprising: anendoscope having a shaft with a lens at a distal end; and a toolconnected to a port of the endoscope via an adjustable arm, where thetool comprises a control and connection to the control for an endoscopeaccessory portion, a sheath, or both, where the endoscope accessoryportion, the sheath, or both extend from the port, through a workingchannel of the shaft, to a distal end aperture out of the shaft, andwhere the control is configured to move the endoscope accessory portion,the sheath, or both, longitudinally in and out of the distal endaperture via rotation of the control, where the endoscope and thecontrol are configured to be used by a single hand of a user at a sametime.
 27. The apparatus as in claim 26 where the tool is an objectremoval tool, where the endoscope accessory portion comprises a basketdevice comprising a basket section adapted to capture an object, andwhere the control is configured to close the basket section around theobject.
 28. The apparatus as in claim 27, where the basket device isadapted to longitudinally slide on the sheath, and where the controlcomprises a cam member having a cam surface adapted to cam against aportion of the basket device as the basket device and cam member arerotated relative to each other.
 29. The apparatus as in claim 28 wherethe control comprises a holder configured to be removably connected to aport of an endoscope and a bracket movably connected to the holder,where a proximal end of the sheath is fixedly connected to the bracket,where the bracket is limited to longitudinally slide along a firstlength of travel of the bracket on the holder and is rotatable on theholder at an end of the first length of travel, where the basket devicecomprises a portion which is located in a cam slot inside the cammember, and where the bracket comprises a first portion in front of thecam member, a second portion behind the cam member, a connection sectionwhich connects the first and second portions to each other, and arotatable member on the connection section contacts the cam member andis configured to rotate on the connection section and the cam member.30. A method, comprising: inserting an object removal tool into a regionof interest, the object removal tool comprising: a basket devicecomprising a basket section; a sheath on the basket device, where thesheath is adapted to longitudinally slide on the basket device; and acontrol connected to the basket device and the sheath, where the controlis configured to longitudinally move the sheath on the basket device toclose the basket section on an object, where the control comprises a cammember having a cam surface adapted to cam against a portion of thesheath as the sheath and the cam member are rotated relative to eachother, where the cam member is configured to longitudinally move thesheath while a proximal end of the basket device remains substantiallystationary, where the cam member rotates a helix which translates therotational motion to longitudinal motion via a pin, where the pin isconnected to the sheath, where the pin extends into a cutout portion ofthe helix; withdrawing the sheath via rotation of the cam mechanism toopen the basket device; capturing the object; extending the sheath viarotation of the cam mechanism to urge the basket device toward a closedposition; and removing the object removal tool from the region ofinterest.